Healthcare Provider Details

I. General information

NPI: 1801838040
Provider Name (Legal Business Name): THOMAS C. ERDMANN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 05/29/2024
Certification Date: 01/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10030 SW 210TH ST
VASHON WA
98070
US

IV. Provider business mailing address

PO BOX 34703
SEATTLE WA
98124-1703
US

V. Phone/Fax

Practice location:
  • Phone: 206-463-3671
  • Fax:
Mailing address:
  • Phone: 253-681-6626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberMD00031253
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD00031253
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: